Hostname: page-component-77f85d65b8-6c7dr Total loading time: 0 Render date: 2026-04-14T06:24:15.285Z Has data issue: false hasContentIssue false
  • English
  • Français

Paroxetine versus Clomipramine in the Treatment of Obsessive–Compulsive Disorder

Published online by Cambridge University Press:  02 January 2018

Joseph Zohar ,
Rajinder Judge  and
Ocd Paroxetine Study Investigators
Joseph Zohar
Affiliation:
Chaim Sheba Medical Centre, Tel-Hashomer, Israel, and Sackler Medical School, Tel-Aviv University, Israel
Rajinder Judge*
Affiliation:
SmithKline Beecham Pharmaceuticals, Harlow, Essex, UK
*
Rajinder Judge, SmithKline Beecham Pharmaceuticals, New Frontiers Science Park, Third Avenue, Harlow, Essex CM19 5AW, UK
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The aim was to assess the effect of a flexible dose of paroxetine, compared with clomipramine and placebo, in obsessive-compulsive disorder (OCD).

Method

In a multinational randomised study, 406 subjects with OCD of at least six months duration received double-blind mediation for up to 12 weeks. Doses were adjusted according to therapeutic effect and side-effects. Primary efficacy measures were the Yale–Brown Obsessive–Compulsive Scale and the National Institute of Mental Health Obsessive–Compulsive Scale. Secondary efficacy measures were the Montgomery–åsberg Depression Rating Scale, Symptom Check-List (90), Clinical Global Impression, and Patients' Global Evaluation.

Results

Paroxetine was significantly more effective than placebo, and of comparable efficacy to clomipramine. Paroxetine had significantly superior tolerability to clomipramine on three measures: CGI efficacy index, anticholinergic adverse events, and adverse events leading to withdrawal.

Conclusion

Paroxetine is as effective as clomipramine in the treatment of OCD. The comparable efficacy and better tolerability of paroxetine suggest that it would be an appropriate treatment for OCD.

Information

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 4 , October 1996 , pp. 468 - 474
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Arminen, S. L., Ikonen, U., Pulkkinen, P., et al (1994) A 12-week double-blind multi-centre study of paroxetine and imipramine in hospitalized depressed patients. Acta Psychiatrica Scandinavica, 89, 382–389.CrossRefGoogle ScholarPubMed
Chouinard, G., Goodman, W., Greist, J., et al (1990) Results of a double-blind placebo-controlled trial of a new serotonin reuptake inhibitor, sertraline, in the treatment of obsessive–compulsive disorder. Psychopharmacology Bulletin, 26, 279–284.Google ScholarPubMed
Dunbar, G. C., Cohn, J. B., Fabre, L. F., et al (1991) A comparison of paroxetine, imipramine and placebo in depressed out-patients. British Journal of Psychiatry, 159, 394–398.CrossRefGoogle ScholarPubMed
Fineberg, N. A., Bullock, T., Montgomery, D. B., et al (1992) Serotonin reuptake inhibitors are the treatment of choice in obsessive compulsive disorder. International Clinical Psychopharmacology, 7 (suppl. 1), 43–47.CrossRefGoogle ScholarPubMed
Fontaine, R. & Chouinard, G. (1985) Fluoxetine in the treatment of obsessive–compulsive disorder. Progress in Neuropsychopharmacology and Biological Psychiatry, 9, 605–608.CrossRefGoogle ScholarPubMed
Freeman, C. P. L., Trimble, M. R., Deakin, F. W., et al (1994) Fluvoxamine versus clomipramine in the treatment of obsessive compulsive disorder, a multicenter, randomised, double-blind, parallel group comparison. Journal of Clinical Psychiatry, 55, 301–305.Google ScholarPubMed
Goodman, W. K., Price, L. H. & Rasmussen, S. A., et al (1989) The Yale–Brown Obsessive Compulsive Scale. Archives of General Psychiatry, 46, 1006–1011 & 1012–1016.CrossRefGoogle ScholarPubMed
Goodman, W. K., McDougle, C. J. & Price, L. H. (1992) Pharmacotherapy of obsessive compulsive disorder. Journal of Clinical Psychiatry, 53 (suppl. 4), 29–37.Google ScholarPubMed
Goodman, W. K., McDougle, C. J., Barr, L. C., et al (1993) Biological approaches to treatment-resistant obsessive compulsive disorder. Journal of Clinical Psychiatry, 54 (suppl. 6), 16–26.Google ScholarPubMed
Greist, J. H. (1992) An integrated approach to treatment of obsessive compulsive disorder. Journal of Clinical Psychiatry, 53 (suppl. 4), 38–41.Google ScholarPubMed
Greist, J. H., Jefferson, J. W., Kobak, K. A., et al (1995a) Efficacy and tolerability of serotonin transport inhibitors in obsessive–compulsive disorder. A meta-analysis. Archives of General Psychiatry, 52, 53–60.CrossRefGoogle ScholarPubMed
Greist, J. H., Chouinard, G., Duboff, E., et al (1995b) Double-blind parallel comparison of three dosages of sertraline and placebo in outpatients with obsessive–compulsive disorder. Archives of General Psychiatry, 52, 289–295.Google Scholar
Jackson, C. W., Morton, W. A. & Lydiard, R. B. (1994) Pharmacologic management of obsessive–compulsive disorder. Southern Medical Journal, 87, 310–321.CrossRefGoogle ScholarPubMed
McTavish, D. & Benfield, P. (1990) Clomipramine: an overview of its pharmacological properties and a review of its therapeutic use in obsessive compulsive disorder and panic disorder. Drugs, 39, 136–153.Google Scholar
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Greist, J. H., McIntyre, A., Osterheider, M., et al (1993) A double-blind placebo-controlled study of fluoxetine in patients with DSM–III–R obsessive–compulsive disorder. The Lilly European OCD Study Group. European Neuropsychopharmacology, 3, 143–152.Google Scholar
Murphy, D. L., Zohar, J., Benkelfat, C., et al (1989) Obsessive–compulsive disorder as a 5-HT subsystem-related behavioural disorder. British Journal of Psychiatry, 155 (suppl. 8), 15–24.CrossRefGoogle Scholar
Parloff, M. B., Kelman, H. C. & Frank, J. D. (1954) Comfort, effectiveness and self-awareness as criteria of improvement in psychotherapy. American Journal of Psychiatry, 111, 343–351.CrossRefGoogle ScholarPubMed
Pigott, T. A., Pato, M. T., Bernstein, S. E., et al (1990) Controlled comparisons of clomipramine and fluoxetine in the treatment of obsessive–compulsive disorder. Archives of General Psychiatry, 47, 926–932.CrossRefGoogle ScholarPubMed
Rasmussen, S. A. & Eisen, J. L. (1992) The epidemiology and clinical features of obsessive compulsive disorder. Psychiatric Clinics of North America, 15, 743–758.CrossRefGoogle ScholarPubMed
Sheehan, D., Dunbar, G. C. & Fuell, D. (1992) The effect of paroxetine on anxiety and agitation associated with depression. Psychopharmacology Bulletin, 2, 139–143.Google Scholar
Stuppaeck, C. H., Geretsegger, C., Whitworth, A. B., et al (1994) A multicenter double-blind trial of paroxetine versus amitriptyline in depressed inpatients. Journal of Clinical Psychopharmacology, 14, 241–246.CrossRefGoogle ScholarPubMed
Tollefson, G. D., Rampey, A.H. Jr., Potvin, J. H., et al (1994) A multicenter investigation of fixed-dose fluoxetine in the treatment of obsessive–compulsive disorder. Archives of General Psychiatry, 51, 559–567.Google Scholar
Turner, S. M., Jacob, R. G., Beidel, D. C., et al (1985) Fluoxetine treatment of obsessive–compulsive disorder. Journal of Clinical Psychopharmacology, 5, 207–212.CrossRefGoogle ScholarPubMed
Weissman, M. M., Bland, R. C., Canino, G. J., et al (1994) The cross national epidemiology of obsessive compulsive disorder. Journal of Clinical Psychiatry, 55 (suppl. 3), 5–10.Google ScholarPubMed

This journal is not currently accepting new eletters.

eLetters

No eLetters have been published for this article.